Individual
FRED BAKER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
BA, TCM
Contact information
Practice address
160 N. BEACH ST., DAYTONA BEACH, FL 32114
(386) 689-5926
Mailing address
160 NORTH BEACH ST., DAYTONA BEACH, FL 32114
(386) 689-5926
(386) 866-2569
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
08/29/2012
Last updated
08/29/2012
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